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BAD ADVICE
 Paul A. Offit, M.D.

BAD ADVICE

Or Why Celebrities, Politicians, and

Activists Aren’t Your Best Source of
Health Information

COLUMBIA UNIVERSITY PRESS

NEW YORK
Columbia University Press
Publishers Since 1893
New York Chichester, West Sussex
cup.columbia.edu
Copyright © 2018 Paul A. Offit
All rights reserved
E-ISBN 978-0-231-54693-5

Library of Congress Cataloging-in-Publication Data

Names: Offit, Paul A., author.
Title: Bad advice: or why celebrities, politicians, and activists aren’t your best
source of health information / Paul A. Offit, M.D.
Description: New York: Columbia University Press, [2018] | Includes bibliographical
references and index.
Identifiers: LCCN 2017056425 (print) | LCCN 2018010525 (ebook) | ISBN
9780231546935 (electronic) | ISBN 9780231186988 (cloth: alk. paper)
Subjects: LCSH: Communication in public health. | Communication in medicine. |
Health in mass media.
Classification: LCC RA423.2 (ebook) | LCC RA423.2 .O34 2018 (print) | DDC
362.101/4—dc23
LC record available at https://lccn.loc.gov/2017056425

A Columbia University Press E-book.

CUP would be pleased to hear about your reading experience with this e-book at
[email protected].

Cover design: Noah Arlow

TO MY WIFE BONNIE, WHO STAYED STRONG AFTER EVERY LAWSUIT AND DEATH
THREAT, AND TO OUR CHILDREN, WILL AND EMILY, WHO WERE MERCIFULLY
OBLIVIOUS.
We live in a society exquisitely dependent on science
and technology in which hardly anyone knows
anything about science and technology.
—CARL SAGAN
 CONTENTS

Prologue: On Being Naïve

1. What Science Is—and What It Isn’t

2. White Mice and Windowless Rooms

3. An Alibi for Ignorance

4. Feeding the Beast

5. To Debate or Not to Debate

6. Make ’Em Laugh

7. Science Goes to the Movies

8. The Emperor’s New Clothes

9. Judgment Day

10. The Nuclear Option

11. Pharma Shill

 12. A Ray of Hope

Epilogue: The End of the Tour

Acknowledgments

Appendix: Blogs and Podcasts

Notes

Selected Bibliography

Index
 PROLOGUE: ON BEING
NAÏVE

Question: How can you tell the difference between introverted

scientists and extroverted scientists?

Answer: When introverted scientists talk to you, they stare

down at their shoes. When extroverted scientists talk
to you, they stare down at your shoes.

I n 1997, an executive producer at a local Fox station in Philadelphia

asked me to appear on her show. It was September, back-to-
school month, and the producer wanted to talk about vaccines. At
the time, I was an associate professor of pediatrics at the Children’s
Hospital of Philadelphia and had been studying vaccines for years. I
thought it would be fun.
When I arrived at the studio the producer explained that the
segment would have more energy if, instead of sitting at the desk
with the two news anchors, I sat in the newsroom. She directed me
to a high, unstable chair that rocked with the slightest movement, a
cameraman just a few feet in front of my face. Because I couldn’t
see or hear the news anchors, who were in a room behind me, the
producer gave me an earpiece, which fit badly.
The segment following mine involved a legal comedy-drama
premiering on Fox called Ally McBeal, starring Calista Flockhart. Ally
McBeal featured several lawyers who wore miniskirts to work.
Finding this fashion statement intriguing, the producer had asked
four models, all in their early twenties, to wear progressively shorter
skirts. Talking animatedly among themselves, the models stood next
to me. People in the newsroom buzzed around, talking, joking,
laughing; one was screaming. My chair rocked back and forth.
At this point, I wondered whether it was possible to be any more
distracted. Where were the clowns, the dancing bears, the jugglers,
the exotic animal handler searching for his escaped scorpion? Then
my earpiece fell out. When I put it back in, I realized that one of the
news anchors was asking me a question. My segment, apparently,
had started. “Dr. Offit, could you tell us what vaccines children get,
how many they get, and when they get them?”
The actual answer to that question in 1997 would have been

Children receive a vaccine to prevent hepatitis B virus at birth and then at one and
six months of age; the combination diphtheria–tetanus–pertussis vaccine at two,
four, six, and fifteen months and again at four years of age; a vaccine to prevent
Haemophilus influenzae type b at two, four, six, and twelve months of age; a polio
vaccine at two, four, and six months and again at four years of age; the
combination measles–mumps–rubella vaccine at twelve months and four years of
age, and the chicken pox vaccine at twelve months of age.

Apart from setting the field of health communication back about

twenty years, there was no way I was going to remember all of that.
The better answer would have been

Children receive several vaccines in the first few years of life to prevent
pneumonia, hepatitis, meningitis, and bloodstream infections, among other
diseases. Parents should make sure that their children are up to date on their
vaccines so that they don’t have to suffer these terrible infections.

I didn’t give either of these answers. I didn’t give the first one
because I couldn’t. And I didn’t give the second one because I was
too inexperienced to realize that you don’t have to answer the
question exactly as asked. Rather I gave a variant of the first answer
during which I got lost in the middle, forgetting which vaccines I had
already mentioned and stumbling over exactly when they were
given. It was pathetic. In fact, it was so pathetic that even the models
stopped talking and stared at me sadly. When it was over, the
producer escorted me out of the newsroom, told me how much she
had appreciated my coming to the studio, and never asked me to
appear on her show again.
Since my Fox interview, I’ve written books about vaccines,
antibiotics, alternative medicine, dietary supplements, megavitamins,
faith healing, and scientific discoveries gone awry. In addition,
between 1980 and 2006, I was part of a team of scientists at the
Children’s Hospital of Philadelphia that invented a vaccine. As a
consequence, I’ve had many more opportunities to interact with the
media. I’ve been interviewed on national morning and evening news
shows, grilled on comedy shows like The Colbert Report and The
Daily Show, collaborated on scientific documentaries on CNN,
Frontline, and Nova, and appeared before congressional
subcommittees. I’ve learned a lot along the way. Now I make a
complete ass of myself much less frequently.
One thing I found that I never would have predicted was that I had
inadvertently put myself in the crosshairs of powerful forces intent on
defeating science: an unholy alliance working against the health of
Americans. By standing up against these groups, which include
hostile activists and personal injury lawyers, I’ve received hundreds
of pieces of hate mail, been the target of four death threats, and
been threatened with three lawsuits. I’ve also been physically
harassed. It’s been an education.
My hope is that by reading this book, people will learn from my
journey through the obstacle course of the current culture. Because
we learn about our health through the opaque prisms of newspapers,
magazines, radio, television, movies, activist groups, industry
representatives, celebrities, politicians, and the internet, we often fail
to understand where the real risks lie. As a consequence, we don’t
always make the best decisions for our health and the health of our
children. This failure to appreciate how culture shapes knowledge
will only cause more needless suffering and death—now and for
generations to come.
 CHAPTER 1

What Science Is—and What It

Isn’t

Science is a method of organizing our curiosity.

—TIM MINCHIN, AUSTRALIAN COMEDIAN, ACTOR, AND MUSICIAN

S cience delivered us out of the Age of Darkness and into the Age
of Enlightenment.
Three hundred years ago, graveyards overflowed with small,
white coffins. Children died from smallpox, meningitis, pneumonia,
whooping cough, bloodstream infections, scarlet fever, diphtheria,
hepatitis, measles, and food poisoning. Of every hundred children
born, twenty would be dead before their fifth birthday. Mothers died
from tuberculosis and childbed fever. Crop failures led to famines
and starvation. Homes were infested with filth and vermin. The
average life span was thirty-five years.
Scientific advances have eliminated most of this suffering and
death. Vaccines, antibiotics, sanitation programs, pest control,
synthetic fertilizers, X-rays, air conditioning, recombinant DNA
technology, refrigeration, and pasteurization—to name just a few—
have allowed us to live longer, better, healthier lives. During the last
hundred years alone, the life span of Americans has increased by
thirty years.
Unfortunately, scientific discoveries have a darker side. Physicists
have given us atomic bombs, which, in 1945, were dropped on
civilian populations in Hiroshima and Nagasaki, killing more than one
hundred thousand people. Chemists have given us opioids like
heroin and fentanyl, which kill about sixty thousand Americans every
year. And, through what are called gain-of-function studies, biologists
have invented ways to make deadly viruses and bacteria even more
contagious; these new microbes have the capacity to cause plagues
more devastating than anyone has ever encountered.
The fear that our reach has exceeded our grasp is reflected in
movies like Frankenstein (1931), Colossus: The Forbin Project
(1970), Westworld (1973), Jurassic Park (1993), 28 Days Later
(2002), Splice (2009), and Ex Machina (2015), each depicting a
world in which science is out of control—something to fear, not
embrace. “Our scientific power has outrun our spiritual power,” said
Martin Luther King Jr. “We have guided missiles and misguided
men.”

••••

LET’S START BY TAKING A STEP BACK AND ASKING A BASIC QUESTION: What is
science?
Stripped to its essence, science is simply a method to understand
the natural world—it’s an antidote to superstition.
In a sense, everyone is a scientist. For example, if a car doesn’t
start, a mechanic considers several possibilities: the battery is dead;
the starter is defective; the car is out of gas; the fuel system is
clogged. Then, the mechanic tests each of these potential problems.
This is exactly how scientists think: hierarchically, reasonably,
logically. It would be unreasonable to think that the car doesn’t start
because the gods were angry or because the owner had cheated on
his taxes. That’s not scientific thinking; that’s magical thinking. And
it’s at the heart of a lot of misconceptions about how the world works
and whether one thing causes another.
By far the most important part of the scientific process is
reproducibility. If a scientist’s hypothesis is right, then other
investigators will confirm that it’s right. If it’s wrong, they won’t. The
beauty of science is that it’s enormously self-correcting, questioning,
probing, skeptical, mutable. Nothing is a fact until it’s reproduced
again and again and again.
 It will probably come as a surprise to learn what science isn’t—it
isn’t scientists or scientific textbooks or scientific papers or scientific
advisory bodies. As once-cherished hypotheses are disproved,
scientists throw away their textbooks without remorse. For some
people, this is unnerving. We want certainty, especially when it
comes to our health. And that’s when we get into trouble—what I’ll
call the “Bones McCoy seduction.”
In the long-running television series Star Trek, Dr. Leonard H.
“Bones” McCoy was the chief medical officer aboard the USS
Enterprise. To make a diagnosis, McCoy briefly scanned the patient
with a hand-held device called a tricorder. He then carefully
examined the read-out. And that was it. If the scanner displayed a
particular diagnosis, then that was the diagnosis. No questions. No
doubts. This kind of certainty is attractive. And it’s why doctors like
Mehmet Oz and Deepak Chopra, who often represent themselves as
all-knowing gurus, are so seductive. They, too, express only
certainty. They, too, know the truth, and their truth is immutable,
fixed. Unfortunately, medical science doesn’t work that way; we’ll
know much more in a hundred years than we know now.
Nevertheless, when our health is at stake, it’s hard to accept that our
knowledge is incomplete.
But take heart—scientific truths do emerge. Sometimes they
emerge over months, sometimes years, and sometimes decades.
But they do eventually emerge. And when these truths emerge, they
become immutable. Evolution and climate change, for example, are
no longer opinions; they’re facts built on a mountain of evidence.
Although we should trust the scientific process, we should be
skeptical of scientists. Scientists get it wrong all the time. But if
they’re wrong, they’ll eventually be shown to be wrong. There’s no
hiding. For example:

• In 1926, Johannes Fibiger, a Danish scientist, won the Nobel

Prize for his discovery of a worm he called Spiroptera carcinoma,
which he believed caused cancer. Fibiger was an instant hero. At
last, the cause of cancer had been found. But Fibiger was later
proven wrong. Worms don’t cause cancer.
 • In 1935, Egas Moniz, a Portuguese neurologist, won the Nobel
Prize for inventing a surgical cure for anxiety, paranoia,
schizophrenia, and bipolar disorder. He called his technique a
leucotomy; when it crossed the Atlantic Ocean, it was called a
lobotomy. The New York Times hailed Moniz as a “brave explorer of
the human brain.” Over the next three decades, more than forty
thousand lobotomies were performed across the globe, twenty
thousand in the United States alone. But lobotomies didn’t cure
anything. Rather, they caused memory loss, seizures, and,
occasionally, fatal, uncontrollable bleeding. By the 1970s, lobotomies
were relegated to the dusty bin of discarded psychiatric therapies,
next to whips, chains, and snake pits.
• In 1957, the American physiologist Ancel Keys published a
paper claiming that people who consumed less fat had a lower
incidence of heart disease, coining the term “heart-healthy diet.”
Keys was a well-respected scientist, a best-selling author, and a
consultant to the World Health Organization and the United Nations.
In 1961, he even appeared on the cover of Time magazine. When
Ancel Keys gave advice, people listened. Because of Keys,
margarine, which contained partially hydrogenated vegetable oils,
became the “heart-healthy” alternative to butter, which contained
animal fats. Although he didn’t realize it at the time, Keys had driven
Americans into the waiting arms of trans fats. Four decades later, the
Harvard School of Public Health estimated that trans fats were
causing about two hundred fifty thousand heart-related deaths every
year.
• In 1981, after interviewing more than four hundred people, Brian
MacMahon concluded that excess coffee drinking increased the risk
of pancreatic cancer. MacMahon, a researcher at the Harvard
School of Public Health, published his findings in one of the most
prestigious medical journals in the world, the New England Journal
of Medicine. However, other scientists couldn’t find what MacMahon
had found. And the notion that coffee enthusiasts risked a universally
fatal cancer faded away.
• In 1989, Stanley Pons and Martin Fleischmann, nuclear
physicists at the University of Utah, made a startling announcement.
They claimed that they had created energy in a test tube by fusing
two small nuclei to form a larger one. This was big news. Nuclear
fusion occurs every day on the sun, the Earth’s greatest source of
energy. But Pons and Fleischmann had created the sun’s energy at
room temperature, providing a clean, inexpensive, and limitless
source. They called their discovery “cold fusion.” Utah legislators
were so proud of this homegrown breakthrough that they allocated
$4 million to establish the National Cold Fusion Institute on the
University of Utah’s campus. When more than seventy other
research teams failed to find what Pons and Fleischmann had found,
the hope of cold fusion died a quiet death. The building that once
housed the National Cold Fusion Institute still stands, a literal
monument to irreproducible science.

Some people hear stories like this and say, “See! That’s why you
can’t trust science. Science gets it wrong all the time.” But they’re
confusing science with scientists. While scientists might have certain
biases—and doggedly stick to those biases—the scientific process
prevails. Lobotomies, cold fusion, cancer-causing worms, and
margarines loaded with trans fats didn’t stand the test of time. In
other words, while it is reasonable to be skeptical of scientists, it is
unreasonable to be skeptical of the scientific process.
In each of these stories, the scientific method won out. But until it
did, the public was misled and confused. The reason was simple.
Although scientists claim, correctly, that it’s all about the data,
scientific data don’t speak for themselves. Someone has to speak for
them. Of all the lessons I’ve had to learn, this one has probably been
the hardest.
I’ll give you a specific example.
A few years ago, Amy Pisani, the executive director of Every Child
By Two, a vaccine advocacy group, asked me to speak to Tom
Harkin, the popular Democratic senator from Iowa. Harkin had
requested that $2 million of the budget of the Centers for Disease
Control and Prevention (CDC) be set aside to determine whether
vaccines were causing developmental disabilities. Every Child By
Two had been founded by the former first lady Rosalynn Carter and
by Betty Bumpers, wife of the longtime senator Dale Bumpers. For
the previous thirty years, these women had worked tirelessly to
ensure that all children in the United States had access to the
vaccines that could save their lives. In the wake of Senator Harkin’s
request, Amy Pisani, Betty Bumpers, and I traveled to Washington,
DC, to try to talk him out of it.
At the time, about two dozen studies had already examined the
relationship between vaccines and developmental disabilities,
including autism. My role in this meeting was to explain the power of
these studies—to reassure Senator Harkin that what he was
proposing to study had already been studied. Harkin was pleasant
and affable, and he asked thoughtful questions. The only interaction
during the meeting that unnerved me occurred as we were leaving.
Amy Pisani and Betty Bumpers left before I did, each shaking
Senator Harkin’s hand. I, too, shook his hand and thanked him. But
he didn’t let go. While holding my hand, he said that a group of
scientists had visited him the previous week and said exactly the
opposite of what I had just said. Who was he supposed to believe? I
told him that it didn’t matter what they said or what I said. The only
thing that mattered was what the data showed. And that he should
be reassured that the studies supporting the safety of vaccines were
well performed and irrefutable. I offered to send him the studies. But
Harkin wasn’t convinced. He continued to hold my hand in his firm
grip. “Can you tell me with confidence that vaccines aren’t causing
permanent damage to children’s brains?” he asked. “Yes,” I said. “I
can.” He continued to stare at me, sizing me up. Was I someone he
could trust?
In the end, Senator Harkin never asked Congress for that $2
million. I was glad that a lot of money wouldn’t be spent testing
something that had already been tested. But in some ways, I felt like
we had probably prevailed for the wrong reasons. For Senator
Harkin, it seemed as if the issue wasn’t determining the relative
quality of scientific studies as much as finding scientists who
appeared to be trustworthy. Although scientists say that it’s always
about the data, the fact remains that most people don’t have the
background to sort out good studies from bad. So they make
decisions based on the believability of whoever is doing the talking.
This means that charismatic scientists with poor data may be more
convincing than awkward scientists with quality data. Appearances
win out.
We are, all of us, at the mercy of fringe scientists with winning
personalities.
 CHAPTER 2

White Mice and Windowless

Rooms

It’s just a lot of little guys in tweed suits cutting up frogs on

foundation grants.
—WOODY ALLEN AS MILES MONROE IN SLEEPER (1973)

I n 2008, John Porter, a Washington, DC, lawyer and former

Republican member of Congress, stood in front of a group of
scientists at a meeting of the American Association for the
Advancement of Science (AAAS). Channeling General George S.
Patton, Porter issued a challenge. “You can sit on your fingers or you
can go outside your comfort zone and get into the game and make a
difference for science,” he said. “Neither we, nor the AAAS, nor any
other group can do it for you. Science needs you. Your country
needs you. America needs you…fighting for science!” According to
Porter, the time had come for scientists to spread out across the
country to explain what they were doing and why they were doing it
—to make their case to the media and to the people.
Although scientists are probably in the best position to explain
science to the public, several factors are working against them—and
they’re not trivial: specifically, their training, their personalities, and
how they and their work are perceived by the public.

••••
IN 2003, WHILE STUDYING FOR HIS ROLE AS A GEOPHYSICIST IN THE movie The
Core, the actor Aaron Eckhart spent time with several real
geologists. To his surprise, they didn’t seem much different from
anyone else. Eckhart noted that scientists were “just as concerned
as you or I about everyday things.” Nonetheless, the stereotypical
images that many people have of scientists—as portrayed on
television shows like The Big Bang Theory and movies like Back to
the Future—isn’t that far from the truth. Scientists are often shy,
quiet, introverted, and thoughtful—far more comfortable working in
isolation than carousing in public. You don’t see scientists doing
stand-up comedy, appearing on reality television shows, or
screaming shirtless in subfreezing weather at football games.
The public’s perception of scientists is consistent and ingrained.
In 1957, the anthropologist Margaret Mead asked thirty-five
thousand American high school students to complete the following
sentence: “When I think of a scientist, I think of…” They wrote, “The
scientist is a man who wears a white coat and works in a laboratory.
He is elderly or middle-aged and wears glasses. He may wear a
beard. He may be unshaven and unkempt. He may be stooped and
tired. He is surrounded by equipment: test tubes, Bunsen burners,
flasks and bottles, and weird machines with dials. He spends his
days doing experiments. He pours chemicals from one test tube to
another. He scans the heavens through a telescope. He peers raptly
through a microscope. He experiments with plants and animals,
cutting them apart. He injects serum into animals. He writes neatly in
black notebooks.”
Twenty-five years later, in 1982, an Australian educator named
David Chambers asked forty-eight hundred elementary school
students to draw a scientist. In each case, the scientist wore a white
lab coat, had unkempt, tousled hair, peered out from behind thick,
dark-rimmed glasses, and was male.
Why were these children so uniform in their responses? Where do
these images come from? In his book Mad, Bad, and Dangerous?
The Scientist and the Cinema, Christopher Frayling explains their
origins.
The wild hair, Frayling argues, comes from the world’s most
famous scientist: Albert Einstein, the human symbol of genius.
Although other iconic scientists like Archimedes, Marie Curie,
Charles Darwin, Galileo, Isaac Newton, Louis Pasteur, Linus
Pauling, James Watson, or Francis Crick equally could have been
revered, Einstein’s universal popularity lies in his simple and easy-to-
remember formula: e = mc2. Albert Einstein is so famous that his
face has become a cultural icon. His wise and sympathetic eyes
appear on E.T. in E.T. the Extraterrestrial (1982), his forehead on
Yoda in Star Wars (1977), and his wild hair on Dr. Emmett Brown
(played by the actor Christopher Lloyd) in Back to the Future (1985).
The white lab coat, writes Frayling, is a “symbol of neutrality,
cleanliness, separation from the rest of the world, and standards—
usually male—of professionalism.” Frayling also proposes a more
ominous meaning. In the mid-1960s, the social psychologist Stanley
Milgram—attempting to understand the horrors of Nazi Germany—
found that people were more likely to submit to authority when the
person running the experiment was wearing a white lab coat. (When
I am filmed in my laboratory, producers invariably ask me to put on a
white lab coat, which I never wear. This, presumably, is to make me
look like I actually know what I’m talking about.)
Thick, black glasses are also part of the uniform. Dr. Clayton
Forrester (Gene Barry) in the original War of the Worlds (1953), the
biologist Diane Farrow (Sandra Bullock) in Love Potion Number 9
(1992), and the MIT graduate David Levinson (Jeff Goldblum) in
Independence Day (1996) all wear thick, black glasses. Coke-bottle
glasses, according to Frayling, “are often an outward and visible sign
of the scientist’s perceived incompleteness as a human being, a
shortsightedness that cuts him or her off from the mainstream.”
In short, we perceive scientists as brilliant in the laboratory but
unfit to navigate the real world. In Independence Day, the wild-eyed,
strange-haired Dr. Brakish Okun (Brent Spiner), the director of
research in Area 51, meets President Thomas J. Whitmore (Bill
Pullman). “Mr. President!” he says. “Wow! This is…what a
pleasure…. As you can imagine, they…they don’t let us out much.”
In I.Q. (1994), Albert Einstein (Walter Matthau) and two other real-life
scientists portrayed by actors pal around in a Three-Stooges–like
buddy movie for geniuses. Collectively, they can’t drive a car or
retrieve a badminton birdie from a tree. “Three of the greatest minds
in the twentieth century,” notes a friend, “and amongst them they
can’t change a light bulb.” Most pathetic is the pick-up line of the
Princeton mathematician John Nash (Russell Crowe) in A Beautiful
Mind (2001): “I don’t exactly know what I’m required to say in order
for you to have intercourse with me.”
In the worst case, the scientist is seen as someone who creates
monsters, either literally, like Frankenstein’s monster, or figuratively,
like genetically modified organisms (GMOs). “In these images of our
popular culture,” wrote the historian Theodore Roszak, “resides a
legitimate public fear of the scientist’s stripped down, depersonalized
conception of knowledge—a fear that our scientists, well-intentioned
and decent men and women all, will go on being titans who create
monsters…the child of power without spiritual intelligence.”
Because only 0.3 percent of Americans are professional
scientists, most people have probably never met one. And so the
stereotypes persist. We have no idea who scientists are, what they
do, or why they do it. One story, and it is no doubt apocryphal,
involves Albert Einstein traveling on a train from New York City to his
home in Princeton, New Jersey. Einstein is explaining his theory of
relativity to a group of journalists gathered around him. An elderly
man sitting across the aisle listens carefully to Einstein’s
descriptions. When the train reaches Princeton, the man sidles up to
Einstein and says, “So tell me, Mr. Einstein. From this you make a
living?”
I’m fairly typical of most scientists. I first started working in a
scientific laboratory in 1981, studying a virus called rotavirus: a
common cause of fever, vomiting, and diarrhea in young children. At
the time, every year in the United States about four million children
were infected with the virus, seventy thousand were hospitalized with
severe dehydration, and sixty died from the disease. Because
rotavirus had only recently been shown to be a cause of human
disease, not much was known about how to prevent it. Our
laboratory was the first to develop a small-animal model using mice
to study this infection. For the next twenty years, every morning I
walked into a small, concrete-blocked, windowless room in the
animal facility at the Wistar Institute in Philadelphia to inoculate mice
and collect their blood, breast milk, and feces. Listening to classical
music, I would spend several hours a day, seven days a week, in the
“mouse house.” As you can imagine, talking to mice every morning
alone in a tiny room wasn’t the best way to prepare for appearances
on The Colbert Report.
Indeed, nothing about my job requires me to be good with people.
On the contrary, it selects for someone who is perfectly comfortable
being apart from people—or at most, working next to them like a
child engaged in parallel play. No schmoozing. No backslapping. No
gathering around the coffee machine to tell interesting stories from
the night before. The opposite of a “people person.”
In fact, scientists are so reticent to appear in public that they are
often appalled when other scientists do it. They feel that these
“celebrity” scientists, by pandering to the media, are selling out; that,
by simplifying their work for the public, they’re lessening its
importance. Perhaps no two people have been punished more for
their frequent media appearances than Carl Sagan, whose award-
winning 1980 television series, Cosmos, sparked an interest in
astronomy among thousands of young people, and Jonas Salk, the
inventor of the first polio vaccine and one of the first scientists to
appear on television. Members of the National Academy of Sciences
—one of the most prestigious scientific organizations in the world—
refused admission to both Sagan and Salk because of their celebrity.
Surely, no real scientists would prostitute themselves by doing what
they had done.
Another force working against scientists is their training. Early on,
scientists learn that the scientific method doesn’t allow for absolute
certainty. When scientists formulate a hypothesis, it’s always framed
in the negative; this is known as the null hypothesis. When
communicating science to the public, the null hypothesis can be a
problem.
I’ll give you an example. Suppose you want to know whether the
measles–mumps–rubella (MMR) vaccine causes autism. The null
hypothesis would be “the MMR vaccine does not cause autism.”
Studies designed to answer this question can result in two possible
outcomes. Findings can reject the null hypothesis, meaning that
autism following the MMR vaccine occurs at a level greater than
would be expected by chance alone. Or, findings cannot reject the
null hypothesis, meaning that autism following the MMR vaccine
occurs at a level expected by chance alone. The temptation in the
first case would be to say that the MMR vaccine causes autism and
in the second that it doesn’t. But scientists can’t make either of those
statements. They can only say that one thing is associated with
another at a certain level of statistical probability.
Also, scientists can never accept the null hypothesis; said another
way, they can never prove never. Brian Strom, formerly the head of
the Center for Clinical Epidemiology and Biostatistics at the
University of Pennsylvania, used to call it “the P word.” He wouldn’t
let his trainees say prove because epidemiological studies don’t
prove anything. When trying to reassure people that a particular
health scare is ill founded, the scientific method can handcuff
scientists.
Here are some practical examples of Brian Strom’s “P-word”
problem. When I was a little boy, I watched the television show
Adventures of Superman, starring George Reeves. One thing that
any child watching that show knew to be true was that Superman
could fly. When you’re five years old, television does not lie. I
believed that if I walked into my backyard, tied a towel around my
neck (to simulate Superman’s cape), and jumped from a chair, I
could fly. After several attempts (spoiler alert), I found that I couldn’t.
But this didn’t prove that I couldn’t fly. I could have tried a million
times, and that still wouldn’t have proved that I couldn’t fly. It would
only have made it all the more statistically unlikely. You can’t prove
that weapons of mass destruction weren’t hidden somewhere in Iraq;
you can only say that they weren’t anywhere that you looked. You
can’t prove that I’ve never been to Juneau, Alaska (even though I’ve
never been to Juneau, Alaska); you can only show a series of
pictures of buildings in Juneau with me not standing next to them.
Scientists know that you can never prove never. The point being
that, unlike mathematical theorems, when it comes to studies
designed to determine whether one thing causes another, there are
no formal proofs—only statistical associations of various strengths.
One example of how the scientific method can enslave scientists
occurred in front of the House of Representatives Committee on
Government Reform. On April 6, 2000, a Republican member of
Congress from Indiana, Dan Burton, certain that the MMR vaccine
had caused his grandson’s autism, held a hearing to air his ill-
founded belief. At the time, one study had already shown that
children who had received the MMR vaccine had the same risk of
autism as those who hadn’t received it. (Since that hearing, sixteen
additional studies have found the same thing.) The scientists who
testified at the hearing, however, knew that no scientific study could
ever prove that the MMR vaccine does not cause autism. They knew
they could never say, “The MMR vaccine doesn’t cause autism.” So
they didn’t. Rather, they said things like, “All the evidence to date
doesn’t support the hypothesis that the MMR vaccine causes
autism.” To Dan Burton, this sounded like a door was being left open
—like the scientists were waffling or worse, covering something up.
“You put out a report to the people of this country that [the MMR
vaccine] doesn’t cause autism, and then you’ve got an out in the
back of the thing,” he screamed. “You can’t tell me under oath that
there is no causal link, because you just don’t know, do you?”
Another force working against scientists is the difficulty of
reducing complex scientific issues into simple sound bites. A
scientist’s instinct is to fully explain an issue—including the nuances
and complicated parts—so that ambiguity can be reduced or
eliminated. Trying to condense a difficult concept into a sentence or
two not only feels intellectually dishonest, it is intellectually
dishonest.
The “sound-bite” problem is impossible to avoid. For example, in
the late 1990s parents became concerned that a mercury-containing
preservative in vaccines called thimerosal might cause autism. At the
time, thimerosal was present in several vaccines given to infants and
young children. The preservative was used in multi-dose vials (which
typically contain ten doses) to prevent contamination with bacteria or
fungi that might have been inadvertently injected into the vial while
removing the first few doses. (Before preservatives were added to
vaccines, these bacteria and fungi occasionally caused severe or
fatal infections.) Exercising caution, the Public Health Service urged
vaccine makers to take thimerosal out of vaccines and switch to
single-dose vials, which would eliminate the need for a preservative.
This would make vaccines more expensive—about 60 percent of the
cost of a vaccine is its packaging—but better safe than sorry.
This wasn’t a trivial issue. The firestorm created by the Public
Health Service’s directive to remove thimerosal from vaccines drew
international media attention and gave birth to at least three anti-
vaccine groups: Generation Rescue, which believed that children
with autism could be cured by removing mercury from their bodies;
SafeMinds, which believed that the symptoms of autism were
identical to those of mercury poisoning; and Moms Against Mercury,
which advocated for mercury-free vaccines. Mercury is never going
to sound good. There will never be an advocacy group called the
National Association for the Appreciation of Heavy Metals standing
up in defense of mercury. Frankly, any parent could reasonably
conclude that if large quantities of mercury can damage the brain
(which they can), then even small amounts like those once contained
in several vaccines should be avoided.
The media had questions. Why was mercury being injected into
babies? And why had the federal government allowed it to happen?
Unfortunately, few scientists stepped up to provide answers. And it’s
easy to understand why. Trying to explain briefly that thimerosal in
vaccines had never caused a problem—and why it never would have
caused a problem—was nearly impossible. To fully explain this
issue, a scientist would have had to have made the following points:
(1) Thimerosal, the preservative in vaccines, is ethylmercury; (2)
environmental mercury, which is the kind of mercury that can be
harmful, is methylmercury; (3) ethylmercury and methylmercury are
different (at this point, you’ve already lost the audience; prefixes like
ethyl and methyl are meaningless; it sounds like you’re talking about
gasoline or alcohol, which also seem like things that shouldn’t be
injected into babies); (4) ethylmercury (thimerosal) is eliminated from
the body ten times faster than methylmercury, which is one of the
reasons that thimerosal doesn’t cause harm; (5) methylmercury is
present in everything made from water on this planet, including infant
formula and breast milk; (6) the quantity of methylmercury in infant
formula and breast milk is much greater than the trace quantities of
ethylmercury that were contained in vaccines; (7) because
methylmercury is ubiquitous in the environment, all children,
including newborn babies, have methylmercury in their
bloodstreams; (8) children injected with ethylmercury (thimerosal)-
containing vaccines have levels of mercury in their bloodstreams
well within those considered to be safe; and (9) seven studies have
shown that children who had received thimerosal-containing
vaccines were no more likely to develop mercury poisoning, autism,
or other developmental problems than children who had received the
same vaccines without thimerosal. Try to reduce that into a ten- or
fifteen-second sound bite for television.
I struggled mightily with the thimerosal issue when speaking with
the media. I would say things like, “Babies are receiving much
greater quantities of mercury from breast milk or infant formula than
from vaccines.” This wasn’t particularly reassuring. Now parents
were scared of everything they were putting into their babies—
trapped in an environmental hell. Or I would say, “Studies have
shown that children who received thimerosal-containing vaccines are
at no greater risk of autism than children who received the same
vaccines without thimerosal.” This, also, wasn’t particularly
reassuring. From the parents’ standpoint, mercury is bad, so it
shouldn’t have been in vaccines in the first place. At one point, I had
to testify in front of a hearing during which a member of Congress
said, “I have zero tolerance for mercury.” What I really wanted to say
was, “Mercury is part of the Earth’s crust. If you have zero tolerance
for mercury, you should move to another planet.” (If you’ve ever
testified in front of Congress, you would understand why having
representatives move to another planet is not the worst idea.)
In the end, thimerosal was removed as a preservative from
virtually all vaccines given to young children, and, because single-
dose vials replaced multi-dose vials, the cost of vaccines increased,
with no benefit. Advocates perceived vaccines as being safer even
though they weren’t. They were just more expensive. Scientists who
stood up for the science on this issue sounded like they didn’t care
about children—like they were perfectly willing to stand back and
watch babies get injected with a heavy metal. In truth, scientists who
stood up for the science of thimerosal were standing up for children.
Because vaccines were now more expensive, they became less
available, putting children at needless risk, especially in the
developing world.
Another factor working against scientists is their commitment to
precise language; as a consequence, they’re intolerant of even the
slightest inaccuracies in how science is portrayed to the public. This,
in combination with the inevitably inverse relationship between the
popularity of a scientific movie or television show and its accuracy,
can make for problems. The most dramatic example of this issue is
the astrophysicist Neil deGrasse Tyson’s reaction to the movie
Titanic.
Released in 1997, Titanic, starring Kate Winslet and Leonardo
DiCaprio, was one of the most popular movies ever made, seen by
an estimated four hundred million people. And its animated depiction
of how and why the RMS Titanic sank was perfect. Although people
didn’t watch the movie because they wanted to learn about the
physics of the RMS Titanic’s sinking, they learned anyway. (Come
for the love story. Stay for the science.) Neil deGrasse Tyson,
however, was appalled at the inaccuracy of one scene, so he sent a
message to James Cameron, the director. “Neil deGrasse Tyson
sent me quite a snarky email saying that, at that time of the year, in
that position in the Atlantic in 1912, when Rose is lying on the piece
of driftwood and staring up at the stars, that is not the star field she
would have seen,” said Cameron. To his credit, Cameron revised the
scene for the 3D version of the film. One can only imagine that of the
hundreds of millions of people who saw Titanic, Neil deGrasse Tyson
was the only one who watched that scene and thought, “That’s not
what the sky in the North Atlantic would have looked like at that time
of the year in 1912! What the hell was James Cameron thinking?”
My favorite movie mistake is in The Wizard of Oz (1939). After the
Wizard gives him a diploma, the scarecrow recites the Pythagorean
theorem: “The sum of the square roots of any two sides of an
isosceles triangle is equal to the square of the remaining side. Oh
joy, rapture, I’ve got a brain!” An isosceles triangle has two equal
sides. The square roots of one of those equal sides plus the third
side cannot possibly equal the remaining one. He should have said,
“The square root of the longest side of a right triangle is equal to the
sum of the squares of the other two sides.” (My children argue that
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